Hospital-based surveillance for radiological pneumonia in children under 5 years of age in Uttar Pradesh and Bihar

Awasthi, Sanjay; Singh, Jai Vir; Kohli, Neera; Agarwal, Monika; Verma, Neelam; Kumar, Chandra Bhushan; Roy, Chittaranjan; Mishra, Kripa Nath; Jain, Pankaj; Yadav, Rajesh Kumar; Pandey, Chandra Kant; Srivastava, Amit Kumar

doi:10.1016/j.pid.2016.06.008

Cited by 6 publications

(19 citation statements)

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“…As a part of a separate study, a surveillance network of public and private hospitals that admitted children < 5 years was formed after obtaining their written, informed consent to participate(Bill & Melinda Gates Foundation Grant No: OPP1118005). Detailed methodology has been published elsewhere [ 19 ]. Children hospitalized in the network hospitals with history of fast breathing with or without chest in-drawing, were screened [ 3 ].Included were children aged 2–59 months, hospitalized with symptoms of WHO defined CAP [ 3 ]who resided in the study index district after informed, written parental consent.…”

Section: Methodsmentioning

confidence: 99%

“…Children hospitalized in the network hospitals with history of fast breathing with or without chest in-drawing, were screened [ 3 ].Included were children aged 2–59 months, hospitalized with symptoms of WHO defined CAP [ 3 ]who resided in the study index district after informed, written parental consent. Excluded were those with cough and respiratory symptoms for more than 14 days (to exclude tuberculosis) [ 19 ]. Included children were followed up in the hospital to assess outcomes such as mortality.…”

Section: Methodsmentioning

confidence: 99%

“…In between their visit, telephonic passive surveillance was done and the hospitals were also encouraged to telephonically contact the surveillance office when a suspected CAP was admitted. In these situations, unscheduled visits were made to such facilities for screening and recruitment [ 19 ]. On hospital visit, surveillance officers screen admission registration of network hospital for potential admissions of CAP.…”

Section: Methodsmentioning

confidence: 99%

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Incidence of community acquired pneumonia in children aged 2-59 months of age in Uttar Pradesh and Bihar, India, in 2016: An indirect estimation

et al. 2019

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IntroductionCommunity Acquired Pneumonia (CAP) is the leading cause of mortality in children younger than five years of age in developing countries, including India. Hence, this prospective study was performed to estimate the incidence of CAP in children (2–59 months)in four districts of Northern India.MethodsA cross-sectional survey in rural Lucknow was conducted using cluster sampling technique to assess the proportion of CAP cases that were hospitalized in last 12 months (hospitalization fraction). Another prospective study was done to assess number of hospitalized CAP cases in same districts in 2016. For this, a surveillance network of hospitals that admitted children was established. Cases with WHO-defined CAP with less than 14 days of illness were eligible for inclusion. Informed written parental consent was obtained. A mathematical model was developed to estimate the incidence of CAP in each district, taking into account number of cases hospitalized in one year, assuming it to be equal to hospitalization fraction and using Lucknow district as reference, correcting for child-population per hospital for each district. Population census data of 2011 was taken as denominator.ResultsIn cross-sectional survey (February to May 2016), 3351 children (2–59 months) from 240 villages were included. Of these 24.58% (824/3351) children suffered from CAP in last 12 months and out of these 4% (33/824) children were hospitalized. Computed incidence of CAP per 1000 child-year for Lucknow was 86.50 (95%CI: 85.72–87.29); Etawah 177.01(95%CI: 175.44–178.58); Patna 207.78 (95%CI: 207.20–208.37) and Darbhanga 221.18 (95%CI: 220.40–221.97). Infants (2–11 months)had almost five to ten times higher incidence of CAP than those in 12–59 months age category.ConclusionsIncidence of CAP in Uttar Pradesh and Bihar is high, being much higher in infants. Hence there is an urgent need for introduction of preventive strategies, improving health seeking behavior and quality of care for CAP.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Incidence of community acquired pneumonia in children aged 2-59 months of age in Uttar Pradesh and Bihar, India, in 2016: An indirect estimation

et al. 2019

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“…As a part of a separate study, a surveillance network of public and private hospitals that admitted children < 5 years was formed after obtaining their written, informed consent to participate(Bill & Melinda Gates Foundation Grant No: OPP1118005). Detailed methodology has been published elsewhere [19]. Children hospitalized in the network hospitals with history of fast breathing with or without chest indrawing, were screened [3].Included were children aged 2-59 months, hospitalized with symptoms of WHO defined CAP [3]who resided in the study index district after informed, written parental consent.…”

Section: Study Methodologymentioning

confidence: 99%

“…Children hospitalized in the network hospitals with history of fast breathing with or without chest indrawing, were screened [3].Included were children aged 2-59 months, hospitalized with symptoms of WHO defined CAP [3]who resided in the study index district after informed, written parental consent. Excluded were those with cough and respiratory symptoms for more than 14 days (to exclude tuberculosis) [19]. Included children were followed up in the hospital to assess outcomes such as mortality.…”

Section: Study Methodologymentioning

confidence: 99%

Incidence of Community Acquired Pneumonia in Children Aged 2-59 Months of Age in Uttar Pradesh and Bihar, India, in 2016: An Indirect Estimation

et al. 2018

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IntroductionCommunity Acquired Pneumonia (CAP) is the leading cause of mortality in children younger than five years of age in developing countries, including India. Hence, this prospective study was performed to estimate the incidence of CAP in children (2-59 months)in four districts of Northern India. MethodsA cross-sectional survey in rural Lucknow was conducted using cluster sampling technique to assess the proportion of CAP cases that were hospitalized in last 12 months (hospitalization fraction). Another prospective study was done to assess number of hospitalized CAP cases in same districts in 2016. For this, a surveillance network of hospitals that admitted children was established. Cases with WHO-defined CAP with less than 14 days of illness were eligible for inclusion. Informed written parental consent was obtained. A mathematical model was developed to estimate the incidence of CAP in each district, taking into account number of cases hospitalized in one year, assuming it to be equal to hospitalization fraction and using Lucknow district as reference, correcting for child-population per hospital for each district. Population census data of 2011 was taken as denominator. ResultsIn cross-sectional survey (February to May 2016), 3351 children (2-59 months) from 240 villages were included. Of these 24.58% (824/3351) children suffered from CAP in last 12 months and out of these 4% (33/824) children were hospitalized. Computed incidence of CAP per 1000 child-year for Lucknow was 86.

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Chest radiograph findings in children aged 2–59 months hospitalised with community-acquired pneumonia, prior to the introduction of pneumococcal conjugate vaccine in India: a prospective multisite observational study

et al. 2020

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ObjectivesThe current study was a hospital-based surveillance of cases hospitalised with WHO-defined community-acquired pneumonia in children aged 2–59 months, to assess the radiological abnormalities in chest X-rays and to identify the demographic and clinical correlates of specific radiological abnormalities, in residents of prespecified districts of Uttar Pradesh and Bihar, India.DesignProspective, active, hospital-based surveillance.SettingMultisite study conducted in a network of 117 secondary/tertiary care hospitals in four districts of Uttar Pradesh and Bihar, India.ParticipantsIncluded were children aged 2–59 months, hospitalised with community-acquired pneumonia, residing in the project district, with duration of illness <14 days and who had not been hospitalised elsewhere for this episode nor had been recruited previously.Main outcome measureConcordant radiological abnormalities in the chest X-rays.ResultsFrom January 2015 to April 2017, 3214 cases were recruited and in 99.40% (3195/3214) chest X-rays were available, among which 88.54% (2829/3195) were interpretable. Relevant radiological abnormalities were found in 34.53% (977/2829, 95% CI 32.78 to 36.28). These were primary end point pneumonia alone or with other infiltrates in 22.44% (635/2829, 95% CI 20.90% to 23.98%) and other infiltrates in 12.09% (342/2829; 95% CI 10.88% to 13.29%). There was a statistically significant interdistrict variation in radiological abnormalities. Statistically significantly higher proportion of abnormal chest X-rays were found in girls, those with weight-for-age z-score ≤−3SD, longer duration of fever, pallor and with exposure to biomass fuel.ConclusionsAmong hospitalised cases of community-acquired pneumonia, almost one-third children had abnormal chest radiographs, which were higher in females, malnourished children and those with longer illnesses; and an intra-district variation was observed.

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Hospital-based surveillance for radiological pneumonia in children under 5 years of age in Uttar Pradesh and Bihar

Cited by 6 publications

References 5 publications

Incidence of community acquired pneumonia in children aged 2-59 months of age in Uttar Pradesh and Bihar, India, in 2016: An indirect estimation

Incidence of community acquired pneumonia in children aged 2-59 months of age in Uttar Pradesh and Bihar, India, in 2016: An indirect estimation

Incidence of Community Acquired Pneumonia in Children Aged 2-59 Months of Age in Uttar Pradesh and Bihar, India, in 2016: An Indirect Estimation

Chest radiograph findings in children aged 2–59 months hospitalised with community-acquired pneumonia, prior to the introduction of pneumococcal conjugate vaccine in India: a prospective multisite observational study

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